scholarly journals Comparative results of the use of transurethral resection and enucleation of the prostate in the treatment of patients with large-sized benign prostatic hyperplasia

2018 ◽  
pp. 50-59
Author(s):  
Д.В. Торбик
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Treatment Group ◽  
Transurethral Resection ◽  
Clinical Results ◽  
Prostatic Hyperplasia ◽  
Average Score ◽  
Control Group ◽  
Urinary Flow ◽  
Endoscopic Techniques ◽  
Comparative Results

В представленном исследовании анализируются среднесрочные клинические результаты внедрения биполярной техники выполнения трансуретральной резекции и энуклеации в лечении доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом более 80 см3. В исследование включено 84 пациента (основная группа), оперированных методом трансуретральной энуклеации предстательной железы, и 112 пациентов – методом биполярной трансуретральной резекции предстательной железы (контрольная группа). При применении исследуемых эндоскопических методов средний срок послеоперационной катетеризации составил 1,3 суток в основной группе и 1,4 дня в группе контроля, интра- и послеоперационные осложнения (кровотечение, инфекционно-воспалительные осложнения) были единичными, причем меньшая частота встречалась в основной группе. Через 6 месяцев после операции скорость потока мочи возросла на 13,9 мл/с в основной группе и на 10,9 мл/с в группе контроля, средний балл по шкале IPSS в итоге составил 3,2±0,2 балла и 4,1±0,1 балла в основной и контрольных группах соответственно (p<0,05). Полученные результаты в основной группе можно связать с большей радикальностью методики трансуретральной энуклеации простаты (ТУЭБ), объем резидуальной ткани узла в этой группе составил 5,6±0,7 см3 против 14,8±3,2 см3 в группе контроля (p<0,05). Таким образом, метод ТУЭБ может быть рекомендован к освоению врачам-урологам специализированных стационаров, как способ оперативного лечения ДГПЖ крупных размеров. In the present study, the mid-term clinical results of the introduction of the bipolar technique of performing transurethral resection and enucleation in the treatment of benign prostatic hyperplasia (BPH) of more than 80 cm3 are analyzed. The study involved 84 patients who underwent transurethral enucleation of the prostate (treatment group) and 112 patients – bipolar transurethral resection of the prostate (control group). In applying the endoscopic techniques under study, the mean duration of postoperative catheterization was 1.3 days in the treatment group and 1.4 days in the control group; intra- and postoperative complications (bleeding, infectious and inflammatory complications) were incidental with lower occurrence in the treatment group. In 6 months after surgery, the urinary flow rate increased by 13.9 mL/s in the treatment group and by 10.9 mL/s in the control group, the average score on the IPSS scale was 3.2 ± 0.2 points and 4.1 ± 0.1 points in the main and control groups, respectively (p <0.05). The results obtained in the main group can be attributed to the more radical methods of transurethral enucleation of the prostate (TEOB), the volume of residual tissue in this group was 5.6 ± 0.7 cm3 against 14.8 ± 3.2 cm3 in the control group (p<0,05). Thus, the TEOB method can be recommended for mastering by urologists of specialized hospitals as a method of surgical treatment of large-size BPH.

Evaluation of mid-term results of bipolar transurethral resection in the treatment of benign prostatic hyperplasia

2018 ◽  
pp. 1-9
Author(s):  
А.С. Векильян
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Blood Loss ◽  
Endoscopic Surgery ◽  
Transurethral Resection ◽  
Operating Time ◽  
Clinical Results ◽  
Massive Bleeding ◽  
Prostatic Hyperplasia ◽  
Surgical Methods

Представлены клинические результаты хирургического лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом до 100 см3 методом биполярной трансуретральной резекции простаты (БТУР -74 пациента) в сравнении с открытой чреспузырной простатэктомией (ОПЭ - 96 пациентов), ранее применявшейся для подобных клинических случаев в урологической клинике "Железнодорожной больницы" г. Волгоград. При статистически равном операционном времени обоих хирургических методов для БТУР отмечено существенное снижение интраоперационной кровопотери, сроков послеоперационной катетеризации и пребывания в стационаре, минимальная частота геморрагических и инфекционно-воспалительных осложнений. Наблюдение за урологическим статусом пациентов в течение первого послеоперационного года показало одинаковую клиническую эффективность сравниваемых хирургических методов. Значительное снижение объема кровопотери в ходе операции БТУР можно считать большим достижением, поскольку улучшение видимости в зоне хирургического вмешательства позволяет оптимизировать гемостаз, предотвратить массивные кровотечения как во время, так и после операции, сократить сроки послеоперационной катетеризации мочевого пузыря, что в свою очередь, снижает частоту развития инфекционно-воспалительных осложнений. Более быстрое восстановление пациентов после эндоскопических операций имеет медико-социальное и экономическое значение, поскольку минимальное количество послеоперационных осложнений и сокращение сроков госпитализации позволяет существенно снизить затраты на лечение и быстрее нормализовать качество жизни пациентов. Полученные результаты демонстрируют перспективность внедрения биполярных методов эндоскопических операций для лечения ДГПЖ в хирургическую практику урологических стационаров в целях повышения безопасности оперативного лечения и экономии затрат на госпитализацию. The clinical results of surgical treatment of benign prostatic hyperplasia (BPH) up to 100 cm3 by bipolar transurethral resection of the prostate (BTUR - 74 patients) in comparison with open transvesical prostatectomy (OPE - 96 patients), previously used for such clinical cases in the urological clinic "Railway hospital" in Volgograd are presented. With statistically equal operating time of both surgical methods, there was a significant decrease in intraoperative blood loss, the terms of postoperative catheterization and hospital stay, the minimum frequency of hemorrhagic and infectious-inflammatory complications. Observation of the urological status of patients during the first postoperative year showed the same clinical efficacy of the compared surgical methods. A significant reduction in the volume of blood loss during the operation, can be considered a great achievement, since the improvement of visibility in the area of surgical intervention allows to optimize the hemostasis, to prevent massive bleeding during and after surgery, to reduce the duration of postoperative bladder catheterization, which, in turn, reduces the incidence of infectious-inflammatory complications. Faster recovery of patients after endoscopic surgery of medical,social and economic importance, as the minimum number of postoperative complications and reduction of hospitalization can significantly reduce the cost of treatment and quickly normalize the quality of life of patients. The results demonstrate the prospects of the introduction of bipolar methods of endoscopic surgery for the treatment of BPH in the surgical practice of urological hospitals in order to improve the safety of surgical treatment and save costs for hospitalization.

scholarly journals Spontaneous prostatic haematoma in a case of benign prostatic hyperplasia

2019 ◽  
Vol 12 (3) ◽  
pp. e228787
Author(s):  
Devanshu Bansal ◽  
Amlesh Seth
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Urinary Bladder ◽  
Urinary Retention ◽  
Transurethral Resection ◽  
Obstructive Uropathy ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Urethral Catheterisation ◽  
Definitive Surgery

A 61-year-old man presented with urinary retention with obstructive uropathy (urea/creatinine: 126/9.2 mg/dL) secondary to a large prostatic haematoma while being medically managed for benign enlargement of the prostate. The patient did not have any fever or local symptoms and the prostate was enlarged and non-tender on examination. Ultrasound and MRI of the pelvis showed a 9.4×10.4×11.1 cm sized prostatic haematoma seen displacing and compressing the urinary bladder anteriorly with bilateral hydroureteronephrosis. The patient was managed with per-urethral catheterisation, haemodialysis and injectable antibiotics. Percutaneous pigtail placement into the prostatic haematoma led to gradual drainage of the haematoma with improvement in the renal parameters. Definitive surgery in the form of transurethral resection of the prostate was done at a later date. Intraoperatively multiple encapsulated cavities containing organised clots were deroofed. On follow-up, the patient did well and had good urinary flow and normal renal parameters.

scholarly journals Effects of Transurethral Resection of Prostate (TURP) on Quality of Life in Case of Benign Prostatic Hyperplasia

2019 ◽  
Vol 5 (2) ◽  
pp. 143-147
Author(s):  
Md Abul Hossain ◽  
Md Akter Alam ◽  
Md Fazal Naser ◽  
Md Shafiqul Azam
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
Flow Rate ◽  
Transurethral Resection ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Transurethral Resection Of Prostate ◽  
Urinary Flow

Background: BPH is one of the most common cause of LUTS which significantly impairs the quality of life. TURP is minimally invasive surgical procedure for Benign Prostatic hyperplasia which has impact on quality of life. Impact on quality of life can be measured by QoL score and effect of TURP can be evaluated. Objective: The purpose of the present study was to evaluate the impact of transurethral resection of prostate (TURP) on Quality of Life (QoL) score. Methodology: This prospective study was carried out in the Department of Urology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, from July 2015 to June 2016. Total fifty patients between 50 to 72 years attending for the treatment of benign prostatic hypertrophy (BPH) with lower urinary tract symptoms (LUTS) were included for the study according to inclusion & exclusion criteria. All of them were evaluated with baseline international prostate symptoms score (IPSS), QoL score, peak urinary flow rate (Qmax), voided volume, voiding time and PVR and were recorded in a predesigned data sheet. Selected patients underwent Transurethral Resection of Prostate. They were followed after 1 month and 3 months with same parameter and compared with the baseline values. Results: The baseline international prostate symptoms score (IPSS) in this study was 25.18±1.45. At one month and three months follow up visits after TURP, the IPSS was decreased to 15.0±1.07 and 8.14±0.76 respectively. There was significant improvement of peak urinary flow rate (Qmax) in the postoperative period, at the 1st follow up visit after one month of TURP (15.78±1.42, p<0.001) and at the 2nd follow visit after three months of TURP (18.78, p <0.001). The mean QoL score was 5.30±0.46 before TURP. After one month of TURP it was 3.20±0.45 and after 3 months of TURP it was 1.86±0.57. Conclusion: There is a significant improvement of quality of after TURP. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 143-147

scholarly journals Efficacy and Safety Evaluation of Transurethral Resection of the Prostate versus Plasmakinetic Enucleation of the Prostate in the Treatment of Massive Benign Prostatic Hyperplasia

2021 ◽  
pp. 1-8
Author(s):  
Jian Zhang ◽  
Yonghui Wang ◽  
Shuang Li ◽  
Shipeng Jin ◽  
Shiqing Zhang ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Clinical Efficacy ◽  
Transurethral Resection ◽  
Statistical Difference ◽  
Operation Time ◽  
Hemoglobin Concentration ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Significant Statistical Difference ◽  
Aging Men

<b><i>Background:</i></b> Benign prostatic hyperplasia (BPH) is a common chronic progressive disease resulting in urinary obstruction in aging men. It comes to more and more patients with massive BPH with the aging of society and extension of life expectancy. <b><i>Objective:</i></b> The aim of the study was to compare the clinical efficacy, safety, and complications between transurethral bipolar plasmakinetic enucleation of the prostate (PKEP) and transurethral resection of the prostate (TURP) in the treatment of massive BPH. <b><i>Design and Setting:</i></b> Patients with BPH were divided into the PKEP group and the TURP group randomly. Intraoperative blood loss (BL), operation time (OT), resected tissue weight (RTW), gland resection ratio (GRR), postoperative indwelling ureter time (IUT), bladder fistula time (BFT) and hospital stay time (HST), preoperative and postoperative serum sodium concentration (SSC), hemoglobin concentration (HGB), prostate weight (PW), postvoid residual (PVR), maximum urinary flow rate (<i>Q</i><sub>max</sub>), international prostate symptom score (IPSS), quality of life (QOL), International Index of Erectile Function (IIEF), and other complications were analyzed and compared respectively. <b><i>Results:</i></b> There was no statistical difference in preoperative IPSS, preoperative QOL score, preoperative PVR, preoperative <i>Q</i><sub>max</sub>, postoperative QOL score, postoperative PVR, postoperative <i>Q</i><sub>max</sub>, IPSS difference value (DV), <i>Q</i><sub>max</sub> DV, and PVR DV between the PKEP group and the TURP group (<i>p</i> &#x3e; 0.05). OT, BL, IUT, BFT, HST, and postoperative IPSS in the PKEP group were significantly lower than that in the TURP group (<i>p</i> &#x3c; 0.01). RTW and GRR in the PKEP group were significantly higher than that in the TURP group (<i>p</i> &#x3c; 0.01). QOL DV in the PKEP group was higher than that in the TURP group (<i>p</i> &#x3c; 0.05). There was statistical difference in SSC DV between the PKEP group and the TURP group (<i>p</i> &#x3c; 0.05). There was significant statistical difference in postoperative PW, postoperative HGB, PW DV, and HGB DV between the PKEP group and the TURP group (<i>p</i> &#x3c; 0.01). There was significant statistical difference in IPSS, QOL, PVR, and <i>Q</i><sub>max</sub> between postoperative value and preoperative value in both groups (<i>p</i> &#x3c; 0.01). The incidence of transurethral resection syndrome, obturator nerve reflex, transient urinary incontinence, and retrograde ejaculation between the PKEP group and the TURP group has no statistical difference (<i>p</i> &#x3e; 0.05). Capsule perforation, blood transfusion, secondary hemorrhage, bladder neck contracture, and urethral stricture in the PKEP group were lower than that in the TURP group (<i>p</i> &#x3c; 0.05). Bladder spasm in the PKEP group was significantly lower than that in the TURP group (<i>p</i> &#x3c; 0.01). There was no statistical difference in preoperative and postoperative IIEF-5, effective erectile frequency, telotism average tension, sustainable telotism average time, and sexual dissatisfaction between the PKEP group and the TURP group (<i>p</i> &#x3e; 0.05). <b><i>Conclusions:</i></b> PKEP and TURP have similar clinical efficacy in the treatment of massive BPH. PKEP has advantages in shorter OT, less BL, more GRR, and fewer complications, but the long-term therapeutic effect of PKEP needs further follow-up.

scholarly journals Intraprostatic Injection of Alcohol Gel for the Treatment of Benign Prostatic Hyperplasia: Preliminary Clinical Results

2006 ◽  
Vol 6 ◽  
pp. 2474-2480 ◽  
Author(s):  
Benjamin T. Larson ◽  
Nelson Netto ◽  
Christian Huidobro ◽  
Marcelo Lopez de Lima ◽  
Wagner Matheus ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Adverse Effects ◽  
Clinical Results ◽  
Prostatic Hyperplasia ◽  
Easy Access ◽  
Urinary Flow ◽  
Prostatic Volume ◽  
Urinary Tract Symptoms ◽  
Gel Injection

Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH.A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20–30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months.The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p< 0.0001) improvements in Qmax, IPSS, and QoL. The mean amount of gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment.This preliminary study presents significant results showing that intraprostatic injection of alcohol gel could be an option for the treatment of BPH and LUTS. The viscosity of the gel allows for accurate imaging under ultrasound, no run back along the needle allowing for multiple methods of delivery, and the gel does not spread to extraprostatic tissue. This new technique could provide a simple and possibly less expensive clinic procedure for treating BPH, and warrants further study.

scholarly journals Phytopreparations in complex treatment of patients with benign prostatic hyperplasia and erectile dysfunction

2018 ◽  
Vol 19 (4) ◽  
pp. 46-53
Author(s):  
A. B. Bat’ko
Keyword(s):  
Erectile Dysfunction ◽  
Benign Prostatic Hyperplasia ◽  
Treatment Group ◽  
Combination Therapy ◽  
Family Doctor ◽  
Prostatic Hyperplasia ◽  
Control Group ◽  
Symptomatic Therapy ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Study Objective

The study objectiveis to evaluate clinical effectiveness of a phytopharmaceutical Vialissil® for treatment of patients with benign prostatic hyperplasia (BPH) and erectile dysfunction.Materials and methods. At the multi-specialty clinic “Family Doctor” (Saint Petersburg) 34 patients aged from 55 to 67 years (mean age 59.6 + 0.7 years) with BPH and concomitant erectile dysfunction without the need for surgical intervention were examined. All patients received previously prescribed symptomatic therapy for BPH and erectile dysfunction (a-adrenoblockers and phosphodiesterase type 5 inhibitors on demand). The treatment group included 18 patients who additionally received Vialissil® as capsules once a day for 30 days. The remaining 16 patients were the control group.Results.After treatment, intensity of general symptoms decreased more in the treatment group than in the control group (by 10 and 4 points, respectively). After the course of therapy, erectile function improved in both groups but only in the treatment group these dynamics were statistically significant. An increase in testosterone level was statistically significant only after combination therapy with Vialissil® (by 16.5 %), and blood level of biologically accessible (active) testosterone increased twofold.Conclusion.Combination therapy for BPH and erectile dysfunction including administration of the Vialissil® phytopharmaceutical more effectively decreases disease intensity compared to standard therapy.

scholarly journals Long-Term Followup after Electrocautery Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
F. Kallenberg ◽  
T. A. Hossack ◽  
H. H. Woo
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Complication Rates ◽  
Urethral Strictures ◽  
Voiding Symptoms ◽  
Stricture Rate ◽  
Historic Data

Introduction. For decades, transurethral resection of the prostate (TURP) has been the “gold standard” operation for benign prostatic hyperplasia (BPH) but is based mainly on historic data. The historic data lacks use of validated measures and current TURP differs significantly from that performed 30 years ago.Methods. Men who had undergone TURP between 2001 and 2005 were reviewed. International prostate symptom score (IPSS), quality of life (QOL) and peak urinary flow rate (Qmax⁡), and postvoid residual (PVR) were recorded. Operative details and postoperative complications were documented. Patients were then invited to attend for repeat assessment.Results. 91 patients participated. Mean follow-up time was 70 months. Mean follow-up results were IPSS—7; QoL—1.5;Qmax⁡—23 mL/s; PVR—45 mL. These were an improvement from baseline of 67%, 63%, 187%, and 80%, respectively. Early complication rates were low, with no blood transfusions, TUR syndrome, or deaths occurring. Urethral stricture rate was higher than anticipated at 14%.Conclusion. This study shows modern TURP still produces durable improvement in voiding symptoms which remains comparable with historic studies. This study, however, found a marked drop in early complications but, conversely, a higher than expected incidence of urethral strictures.

The advantages of bipolar transurethral enucleation for the treatment of benign prostatic hyperplasia of large size

2018 ◽  
pp. 21-30
Author(s):  
А.В. Кузнецов ◽  
И.В. Ларичев ◽  
А.Ю. Попова
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Clinical Results ◽  
Massive Bleeding ◽  
Prostatic Hyperplasia ◽  
Control Group ◽  
Medium Term ◽  
Total Period ◽  
Large Size ◽  
The City

Представлена оценка среднесрочных клинических результатов внедрения биполярной техники выполнения трансуретральной энуклеации (ТУЭБ) доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом свыше 80 см3. Исследование проведено на базе урологического отделения «Дорожной клинической больницы на станции Воронеж-1 ОАО «РЖД» города Воронежа, где применение метода ТУЭБ для хирургического лечения ДГПЖ началось с 2016г. В исследование включено 67 пациентов (основная группа), оперированных методом ТУЭБ, и 79 – методом открытой чреспузырной простатэктомии (ОПЭ, контрольная группа). Применение ТУЭБ позволило в 3 раза сократить срок послеоперационной катетеризации и в 2 раза - объем кровопотери во время операции и общий срок госпитализации. При этом количество операционных осложнений было достоверно меньшим в сравнении с ОЧПЭ, а показатели эффективности оперативного лечения статистически равные. Полученные результаты позволили рекомендовать метод ТУЭБ к широкому применению в урологических клиниках в качестве стандарта хирургического лечения ДГПЖ крупных размеров. Эндоскопический аналог открытой операции следует активно внедрять в хирургическую практику лечения ДГПЖ, что позволит снизить инвазивность оперативного лечения за счет уменьшения риска развития массивных кровотечений и многих других осложнений, а также повысить эффективность использования профильного коечного фонда и экономить средства стационара за счет сокращения продолжительности госпитализации. The evaluation of the medium-term clinical results of the introduction of bipolar technique of transurethral enucleation (TUEB) of benign prostatic hyperplasia (BPH) with a volume of more than 80 cm3 is presented. A study conducted at the urology Department of the clinical hospital at the station Voronezh-1 JSC "RZD" of the city of Voronezh, where the application of the method of TWEB for surgical treatment of BPH began with 2016. The study included 67 patients (main group) were operated by TUEB and 79 by the method of open transvesical prostatectomy (OTP, control group). The use of TUEB made it possible to reduce the period of postoperative catheterization by 3 times and the volume of blood loss during the operation and the total period of hospitalization by 2 times. At the same time, the number of surgical complications was significantly lower in comparison with OTPE, and the indicators of the effectiveness of surgical treatment were statistically equal. The obtained results made it possible to recommend the TUEB method for wide application in urological clinics as a standard of surgical treatment of large-size BPH. The endoscopic analogue of open surgery should be actively introduced into surgical practice of treatment of BPH, which will reduce the invasiveness of surgical treatment by reducing the risk of massive bleeding and many other complications.

Sign in / Sign up

Export Citation Format

Share Document